Guidelines for adolescent preventive services: a role for the school nurse.

Morbidity and mortality for today's adolescent are linked most often to complex behavioral and psychosocial risk factors than in the past. The American Medical Association has developed Guidelines for Adolescent Preventive Services (GAPS) to assist the primary health practitioner in deterring adolescents from participating in health-debilitating behaviors and to promote health-enhancing behaviors. Studies have affirmed usefulness of the GAPS protocol in the private practitioner's office and in the school-based clinic. This paper explores the possibility of using the traditional school nurse to deliver the GAPS in collaboration with school and community professionals. Issues explored include identifying students for he screening, administering the survey, triage of students, interdisciplinary and interagency collaboration, confidentiality, barriers, and time constraints.

Program management: a necessary component for the comprehensive school health program.

The definition of a comprehensive school health program changed dramatically in the 20th century. Publication of the book Health Education, in the 1920s, provided a vision of health education as an instructional experience. In the 1950s, the concept of school health programs grew with addition of components in health services and a healthy school environment. An expanded concept of comprehensive school health programs now includes the components of physical education, food services, counseling, staff health promotion programs, and involvement of parents and the community. The next step involves inclusion of a "focusing" or "integrating" component that unifies elements of the comprehensive school health model. This component provides leadership and management to ensure that potential benefits of a comprehensive school health program are fully realized.

A model to increase consumption of fruit and vegetables by implementing the "5-A-Day" initiative.

The National Cancer Institute, in conjunction with the Produce for Better Health Foundation, launched a 5-A-Day initiative to increase fruit and vegetable consumption. State departments of health in 24 states were licensed to participate to implement behavior change interventions at the community level aimed at both adults and children. This article describes how schools could use the eight components of the expanded school health program to initiate a 5-A-Day program, and why schools need to participate in the 5-A-Day initiative. Specific strategies to implement in each component of the comprehensive school health program are described.

The 1993 ASHA membership survey: members speak up.

Professional organizations, to better serve their members, must strive to communicate regularly with the membership at large and to learn about members' needs, interests, and personal and professional status. The membership survey of the American School Health Association was sent to a stratified random sample of 500 members. A 68% response rate was achieved after a presurvey announcement and two follow-up mailings. Collected data was subjected to descriptive analysis and the chi-square test of significance. Survey findings indicated most ASHA members are satisfied with the overall operation and services of the Association. Data revealed satisfaction with overall quality, format, content, and appearance of the Journal of School Health. The ASHA national school health conference, The PULSE, and other ASHA publications also received strong approval. One-half the respondents reported they are required to earn continuing education credit. More than two-thirds of respondents had never attended a national conference. Overall ratings of various ASHA functions were statistically related to age, gender, income level, educational background, and primary discipline.

A study of confidential unit exclusion.

The effectiveness of the confidential unit exclusion (CUE) procedure recommended by the Food and Drug Administration has been questioned by the blood banking community. The purpose of this study was to determine whether donors were informing the blood center correctly regarding the disposition (transfuse or do not transfuse) of their donated blood. A letter explaining the confidential study and requesting permission to send the participant a questionnaire noting his or her self-exclusion choice was mailed to 230 donors who had chosen transfuse and 276 donors who had chosen do not transfuse. After consent was obtained, participants were sent a second packet and asked to indicate whether they had chosen correctly and, if not, to identify reasons for that incorrect choice. A seven-word terminology quiz made up of words from the CUE form was also enclosed. All participants who had chosen transfuse indicated that this was the correct choice. Approximately 50 percent of those who had chosen do not transfuse indicated that this was an incorrect choice; the most common reason was that "I was not paying attention." The most frequently misunderstood term was "confidential." Donors who chose do not transfuse had a significantly higher rate of error on the terminology quiz (p less than 0.01) than did those who chose transfuse.

The ASHA national HIV education needs assessment of health and education professionals.

The self-reported HIV education needs of teachers, PTA presidents, school administrators, school nurses, school board members, school counselors, and physicians (N = 2,855) were investigated. Resources, policy, training, and knowledge needs were assessed. Greatest reported needs for HIV resources included books, pamphlets, journal articles, films, and videos. More than half the respondents needed information on how to promote school health education programs as well as information on how to coordinate school-based HIV education programs with community, health, religious, and youth agencies. Respondents also indicated a need for model HIV policies on confidentiality, grade level appropriate HIV education, attendance for infected staff and students, and handling blood or body fluids. Training needs included updates on homosexuality and bisexuality, sexually transmitted diseases, risk behaviors for HIV transmission, intravenous drug use, death and dying, safer sex practices, and communicating about HIV with a sexual partner. Knowledge about HIV generally was high, but gaps were apparent regarding effects of HIV on the brain, transmission issues, prevention practices, and HIV antibody testing. Eighty-seven percent believed school-based health education is effective in preventing the spread of HIV. Respondents felt primary responsibility for conducting HIV education should rest with teachers (36%), parents (27%), and school nurses (26%).

A theoretical approach to school-based HIV prevention.

To develop effective school-based programs to prevent the spread of AIDS, programmers must apply principles related to learning and behavior change. Due to the complexity of influencing contemporary adolescent sexual behavior, a multidisciplinary approach using multiple intervention strategies is essential. Health promotion efforts should include policy mandates, direct intervention, instruction, environmental support, media, role modeling, and social support. Consistent, continuous messages through multiple channels (school, home, community, and media) and by multiple agents (parents, peers, and health and education professionals) need to be provided. Examples of appropriate intervention strategies that may be employed by the professionals working in the school and the community are provided.

Schools as agents for achieving the 1990 Health Objectives for the Nation.

This article clarifies the capacity of the nation's public schools to act as powerful and effective agents to facilitate attainment of the 1990 Health Objectives for the Nation. Of the health promotion and disease prevention objectives established by the Department of Health and Human Services in 1980, Iverson and Kolbe have identified 67 that can be achieved directly or indirectly through comprehensive school health programming. This process, however, can best be expedited by expanding the traditional definition of comprehensive school health from one that includes health instruction, health services, and a healthful school environment coordinated by a school/community health council to one that integrates additional programs and resources already in existence in most school and community environments: the physical education program, the school food service program, the school counseling program, and a school site health promotion initiative for faculty and staff. All eight of these areas can be utilized as highly valuable resources to facilitate the attainment of the health objectives for the nation. This schematic, first advanced by Kolbe, includes those diverse programs which have as their objectives the promotion of some aspect of health, either for students or staff, within the school setting. Specific suggestions for programming to attain those 1990 health objectives via an integrated school-based approach are discussed.

Integrated school and community programs.

Collaboration and coordination among school nurses, health teachers, guidance counselors, food service directors, principals, administrators, parents, and community agencies have the potential to upgrade school health programs. Benefits derived from an integrated school and community program are documented. Three models that have effectively brought together schools and community agencies are described.

Report of the 1984 ASHA membership survey.

The results of the most recent American School Health Association (ASHA) membership survey, conducted by ASHA to retain its continuing education units provider status granted in 1981 by the American Nurses' Association are reported. Results of the 1984 survey are compared to two previous surveys, conducted in 1980 and 1982. Topics examined include membership demographics, attendance at national meetings, continuing education needs and preferences, maintaining professional competence, professional issues of importance to readers, and options for improving the usefulness of the Journal of School Health. Several membership trends are discussed and implications for future planning are noted.